Forest-Warren

Human Services

Summa Akron City ER is one of three sites in nationwide mental-health study

Akron Beacon Journal - 9/14/2018

Sept. 14--Summa Health'sAkron City Hospital is one of three sites nationwide chosen to participate in a study to identify patients at a higher risk for mental health problems after a sudden illness or injury.

The other sites are Stanford Hospital in Palo Alto, Calif. and the University of Baltimore Medical Center.

The goal of the study is to develop a screening tool that could be used nationwide to help assess a patient's risk for developing mental-health problems after a sudden serious illness or injury, said Patrick Palmieri, director of Summa's Traumatic Stress Center.

He is co-investigator in the four-year, $2.7 million study funded by the National Institute of Minority Health and Health Disparities. The principal investigator is Eve Carlson of the National Center for PTSD and VA Palo Alto Health Care System. Palmieri and Carlson have conducted research together for several years.

In the general population, exposure to a traumatic experience is very common, said Palmieri.

"There's lots of different types of trauma," which can include classic examples such as military combat trauma, sexual assault, or an accident in a motor vehicle, workplace or in the home, he said. But they can also include things such as living through a natural disaster or an act of terrorism, he said. National estimates predict 55 to 65 percent of the population will experience at least one traumatic experience in their lifetime and one third will have three or more, Palmieri said.

"Many people weather the storm, so to speak, and can recover without any long-term mental-health difficulties. It could be because they have a good social support network. A subset (about 20 percent) of those who experience a trauma develop a mental-health problem or substance abuse, he said.

Palmieri said people often intertwine the use of trauma and PTSD (post traumatic stress disorder), which is a mistake.

Those with PTSD can have intrusive thoughts, or continue to re-experience the trauma, have recurring nightmares or strong emotional or physical reactions, he said. Some patients avoid people or places or things that might trigger the emotional reaction or may turn to alcohol or substance abuse as a coping response.

The study is looking for the likelihood that patients in the ER with a sudden illness or injury and who are subsequently hospitalized will potentially develop a mental-health issue.

"We know a lot of people get traumatized and some of them develop longer-term problems. We don't really know which one of these recently traumatized people are going to have difficulty six or eight months down the road. That's like the Holy Grail of the mental health industry, "said Palmieri.

Some patients have strong symptoms, such as stress, anxiety or depression, right away and over time may recover, even without any formal intervention, said Palmieri. Others may show no signs right away, but may develop symptoms later, he said.

"We're not assessing PTSD or even early PTSD, we're assessing the PTSD risk," he said.

The study will include a large number of racial minority patients, who traditionally have not been well represented in mental-health research, Palmieri said.

Initially, 500 patients at each site will be recruited and surveyed. Identified patients will be asked to take an online survey and then do a clinical interview two and six months later. Phase two will include another 500 patients at each hospital.

If patients indicate they have potential mental-health issues, the researchers will alert the patient's care team, Palmieri said.

"We're not altering in any way the care they would otherwise get," he said.

The surveys began in recent weeks at Summa.

"If we can identify early on, before someone is experiencing any symptoms, we can monitor them more closely or if they are already having some initial symptoms, we might be able to intervene to prevent a full blown PTSD attack or limit the severity of it.

"A lot of people view PTSD as a life sentence. It really isn't. There are effective treatments for PTSD and other trauma-related illnesses," Palmieri said.